Provider Demographics
NPI:1164081436
Name:CID, VERONICA (L AC)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:CID
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8861 SW 142ND AVE APT 9-35
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4025
Mailing Address - Country:US
Mailing Address - Phone:787-901-4928
Mailing Address - Fax:
Practice Address - Street 1:8861 SW 142ND AVE APT 9-35
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4025
Practice Address - Country:US
Practice Address - Phone:787-901-4928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4057171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist